本文選題：血脂異常 + 心血管危險(xiǎn)因素　； 參考：《中國人民解放軍醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:探討老年體檢人群2009-2013年血脂異常變化及血脂異常和相關(guān)心血管危險(xiǎn)因素(CRF)聚集與主要心腦血管疾病(CVD)的關(guān)系。方法:收集2009年和2013年在部隊(duì)醫(yī)院例行體檢的大樣本老年離退休人群數(shù)據(jù)。第一部分納入2009年31382例(男性占94.27%), 2013年30361例(男性占93.49%)研究對象,分析老年血脂異常的患病特點(diǎn)及5年間主要血脂組分異常的變化情況,并對去除藥物影響后人群重復(fù)上述分析;第二部分利用2013年體檢數(shù)據(jù),納入30361例(男性占93.49%)研究對象,分析血脂異常和CRF(高血壓、糖尿病和肥胖)聚集狀況,并利用logistic回歸模型計(jì)算危險(xiǎn)因素聚集與冠心病和缺血性腦卒中的患病關(guān)聯(lián)。CVD定義為至少患冠心病或缺血性腦卒中的一種。結(jié)果:第一部分結(jié)果顯示,老年血脂異常男性以低HDL和高TG為主,女性以高TG和高TC為主。不論年份,高TC、高TG和高LDL-C患病率女性大多高于男性(p0.05),低HDL-C患病率男性高于女性(p0.05)。男性、女性(2013年)低HDL-C患病率隨年齡增長整體呈上升趨勢(p0.05);總的血脂異常,男性高TC、高TG和高LDL-C(2013年)患病率整體呈下降趨勢。年份間對比,男性高TC、高TG(60-79歲)和高LDL-C(70-79歲)患病率下降,2009年高于2013年;血脂異�；疾÷屎湍行缘虷DL-C(60-79歲)患病率增加,2009年低于2013年。第二部分結(jié)果顯示,研究對象的血脂異常和CRF聚集現(xiàn)象明顯,尤其在男性中。男性血脂異常人群同時(shí)具有≥2項(xiàng)危險(xiǎn)因素的比例是無血脂異常人群的1.59倍。多因素logistic結(jié)果顯示,冠心病患病風(fēng)險(xiǎn)隨血脂異常聚集的危險(xiǎn)因素項(xiàng)數(shù)增多而明顯增加。男性血脂異常無伴隨,伴1項(xiàng)和伴≥2項(xiàng)危險(xiǎn)因素時(shí)患冠心病的OR值(95%CI)分別為 1.24(95%CI: 1.12-1.38)、1.78(95%CI: 1.62-1.95)和 2.35(95%CI:2.09-2.64),女性分別為 0.90(95%CI: 0.64-1.26)、1.42(95%CI: 1.02-1.96)和2.15(95%CI: 1.34-3.47)。男性人群缺血性腦卒中的結(jié)果與之類似,相應(yīng)的OR值(95%CI)分別為 1.02(95%CI:0.82-1.26) 、 1.67(95%CI: 1.40-1.99)和1.81 (95%CI: 1.46-2.25),女性人群缺血性腦卒中風(fēng)險(xiǎn)尚不能定論。結(jié)論:老年人群血脂異常流行特征存在明顯性別差異,5年間男性低HDL-C患病率明顯上升,同時(shí)血脂異常與CRF聚集顯著增加CVD的患病風(fēng)險(xiǎn),應(yīng)關(guān)注其獨(dú)立和聯(lián)合作用的風(fēng)險(xiǎn)防控。
[Abstract]:Objective: to investigate the relationship between hyperlipidemia and the accumulation of serum lipid abnormality and related cardiovascular risk factors (CRF) and CVD in elderly people with major cardiovascular and cerebrovascular diseases (CVD) from 2009 to 2013. Methods: the data of large sample of elderly retirees who underwent physical examination in military hospitals in 2009 and 2013 were collected. In the first part, 31382 cases (94.27% male) and 30361 cases (93.49% male) were included in the study in 2009 to analyze the characteristics of senile dyslipidemia and the changes of main lipid components in the past five years. In the second part, 30361 subjects (93.49 males) were included in the study based on the data of physical examination in 2013 to analyze dyslipidemia and CRF (hypertension, diabetes and obesity). Logistic regression model was used to calculate the association between risk factors aggregation and coronary heart disease and ischemic stroke. CVD was defined as at least one type of coronary heart disease or ischemic stroke. Results: the results of the first part showed that low HDL and high TG were the main causes of dyslipidemia in elderly men, and high TG and high TC in females. In both years, the prevalence of high TC, high TG and high LDL-C in females was higher than that in males, and the prevalence of low HDL-C in males was higher than that in females. The prevalence rate of low HDL-C in males and females (2013) increased with the increase of age (p 0.05), and the prevalence rate of high TC, high TG and high LDL-C (2013) decreased in males. Compared with other years, the prevalence of high TC- (high TG(60-79) and high LDL-C(70-79 (age) decreased in men, and the prevalence of dyslipidemia and low HDL-C(60-79 in men increased in 2009, which was lower than that in 2013. The results of the second part showed that abnormal blood lipids and CRF aggregation were observed, especially in men. The proportion of men with dyslipidemia and 鈮，

本文編號：1777180